<!-- INCLUDE header.tpl -->
    	<div style="width:25%; float:left;">
            <div style="margin-left:auto; margin-right:auto;">
            	<!-- INCLUDE sidebar-{CURRENT_PAGE}.tpl -->
            </div>
        </div>
    	<div style="width:75%; float:right;">
            <div class="main-box">
            	<h4 class="rounded-top rounded-bottom">{L_25_0010}&nbsp;&gt;&gt;&nbsp;{L_25_0005}</h4>
				<form name="profile_feilds" action="" method="post">
<!-- IF ERROR ne '' -->
					<div class="error-box"><b>{ERROR}</b></div>
<!-- ENDIF -->
                    <table width="98%" cellpadding="0" cellspacing="0" class="blank">
                    <tr valign="top">
                        <td width="50%">{L_781}</td>
                        <td>
                            {L_030}<input type="radio" name="birthdate" value="y" <!-- IF REQUIRED_0 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="birthdate" value="n" <!-- IF ! REQUIRED_0 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="birthdate_regshow" value="y" <!-- IF DISPLAYED_0 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="birthdate_regshow" value="n" <!-- IF ! DISPLAYED_0 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_782}</td>
                        <td>
                            {L_030}<input type="radio" name="address" value="y" <!-- IF REQUIRED_1 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="address" value="n" <!-- IF ! REQUIRED_1 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="address_regshow" value="y" <!-- IF DISPLAYED_1 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="address_regshow" value="n" <!-- IF ! DISPLAYED_1 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_783}</td>
                        <td>
                            {L_030}<input type="radio" name="city" value="y" <!-- IF REQUIRED_2 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="city" value="n" <!-- IF ! REQUIRED_2 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="city_regshow" value="y" <!-- IF DISPLAYED_2 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="city_regshow" value="n" <!-- IF ! DISPLAYED_2 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_784}</td>
                        <td>
                            {L_030}<input type="radio" name="prov" value="y" <!-- IF REQUIRED_3 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="prov" value="n" <!-- IF ! REQUIRED_3 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="prov_regshow" value="y" <!-- IF DISPLAYED_3 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="prov_regshow" value="n" <!-- IF ! DISPLAYED_3 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_785}</td>
                        <td>
                            {L_030}<input type="radio" name="country" value="y" <!-- IF REQUIRED_4 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="country" value="n" <!-- IF ! REQUIRED_4 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="country_regshow" value="y" <!-- IF DISPLAYED_4 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="country_regshow" value="n" <!-- IF ! DISPLAYED_4 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_786}</td>
                        <td>
                            {L_030}<input type="radio" name="zip" value="y" <!-- IF REQUIRED_5 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="zip" value="n" <!-- IF ! REQUIRED_5 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="zip_regshow" value="y" <!-- IF DISPLAYED_5 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="zip_regshow" value="n" <!-- IF ! DISPLAYED_5 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top">
                        <td>{L_787}</td>
                        <td>
                            {L_030}<input type="radio" name="tel" value="y" <!-- IF REQUIRED_6 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="tel" value="n" <!-- IF ! REQUIRED_6 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    <tr valign="top" class="bg">
                        <td>{L_780}</td>
                        <td>
                            {L_030}<input type="radio" name="tel_regshow" value="y" <!-- IF DISPLAYED_6 -->checked="checked"<!-- ENDIF -->>
                            {L_029}<input type="radio" name="tel_regshow" value="n" <!-- IF ! DISPLAYED_6 -->checked="checked"<!-- ENDIF -->>
                        </td>
                    </tr>
                    </table>
                    <input type="hidden" name="action" value="update">
                    <input type="hidden" name="csrftoken" value="{_CSRFTOKEN}">
                    <input type="submit" name="act" class="centre" value="{L_530}">
				</form>
            </div>
        </div>
<!-- INCLUDE footer.tpl -->